Antidepressants and anxiety medication were the cause of half the intentional overdoses treated in the first five months of this year, The Sunday Times of Malta has learnt.
Mater Dei Hospital documents seen by this newspaper showed that 42 out of the 82 intentional overdoses treated between January and May were the result of the premeditated misuse of psychiatric medication.
“The most common cause of self-harm is depression,” Mental Health Services chairman Anton Grech said when contacted.
“The medication being abused, such as benzodiazepine, is a clear indication that the victim or a relative is undergoing psychiatric treatment and has easy access to the drug, whose prescription is very controlled,” he added.
This newspaper asked for a breakdown of the drugs used after Health Parliamentary Secretary Chris Fearne recently told Parliament that 148 persons had been discharged from hospital after suffering an overdose. Benzodiazepine, more commonly known by its brand name Valium, was the leading cause of intentional overdose – one in three of the planned overdoses were the result of the intentional misuse of the substance.
A psychoactive medication, it is commonly prescribed in cases of severe anxiety. Often referred to as a ‘silencer’, the substance inhibits brain activity by blocking neurons, in what users often call ‘quietening’.
Access to the drug is highly controlled by the government’s dangerous drugs schedule which obliges patients to present monthly prescriptions and a special permit issued by the Health Department on the recommendation of a psychiatrist.
Despite this, nearly the same amount of people who planned to “self-poison” resorted to antidepressants, while some 10 per cent of the overdoses were caused by cocktails of the two drugs mixed together.
Dr Grech said the main preventive measure for suicide was curing depression by accepting it as a mental illness and decreasing the stigma so that people found it less discouraging to seek treatment.
Although Malta did not have robust figures for the rate of depression, it followed European trends where about 20 per cent of the population suffered an episode of severe depression at some point in their life.
“It’s important to raise awareness as in 80 per cent of the cases those contemplating suicide would have clearly stated their intentions to end their life so those around them need to be on the lookout,” he added.
The figures showed that not all overdoses were the result of illegal or controlled drugs. In fact, one in six used over-the-counter headache tablets. One person even turned to hay fever medication to self-harm.
Contrary to popular belief, illegal drugs, such as heroin and cocaine, only accounted for five per cent of the intentional misuse, the same as those caused by sleeping pills.
However, Dr Grech believed this was because those abusing illegal drugs were too scared to seek help at hospital because of the repercussions linked to such criminal activity.
He welcomed the proposal in the White Paper on drug reform to considerably reduce the penalties slapped on those who sought medical treatment for a friend who overdosed. In the past there have been cases where a person dying of an overdose was abandoned because they feared the consequences.
The documents reveal that in 51 cases, doctors could not tell whether the overdose was intentional or not. A quarter of these were caused by the misuse of headache tablets, while anxiety and depression medication made up the majority of the remaining cases.
The main cause of accidental poisoning was paracetamol – three out of 15 unintentional overdoses – but Dr Grech questioned how anybody could swallow a lot of headache tablets by mistake.
“Not unless they underestimated their effect and took too much paracetamol to ease the pain without realising. The most important step in decreasing rate of self-harm is tackling depression. We’re working hard on this, but we can always do better.”